Purpose: Establishing healthy and sustainable dietary habits in childhood is necessary for the prevention of obesity, as well as for the growing pressure on our ecosystems. Parents are the most important actors in affecting dietary behaviors of their children. Even though determinants of healthy food choices among parents have been studied, we still lack specific insight among families with lower socio-economic status (SES) as well as knowledge on determinants of sustainable food choices. To our knowledge, this is the first study that aims to investigate differences in individual and environmental determinants of both healthy and sustainable food choices among lower and higher SES parents.

Methods: A focus group study was conducted among Belgian lower and higher SES parents. A semi-structured interview guide was developed based on the socio-ecological model. The audio taped interviews were transcribed, and a thematic analysis of the transcripts was conducted. Due to covid-19 restrictions, data saturation was only reached for higher SES parents, more focus groups are planned for spring 2021 among lower SES parents.

Preliminary Findings: Fifteen focus groups (n=75) were conducted, including six among lower SES (n=20), and nine among higher SES parents (n=55). Most parents in both SES groups indicated sustainable food choices to be less important than healthy choices. Lower SES parents reported the price of healthy foods as a main barrier, along with knowing that their children will not eat certain foods, and not knowing which recipes to make and how. Higher SES parents mentioned time as main barrier to choose healthy. Both SES groups indicated a lack of knowledge on sustainable foods, its higher price, and personal preferences as important barriers. Additionally, busy lives and a lack of time hinders sustainable choices among higher SES parents while lower SES parents seemed less open to change their meat-eating habits.

Conclusions: Given the mentioned barriers, we can conclude that for higher SES parents an intervention focusing on sustainable food choices would be most beneficial, whereas for lower SES parents interventions should take into account price as main determinant, as well as knowledge, skills and motivations for both healthy and sustainable food choices.

Background: Not much is known about the effect of life-events, specifically parenthood and change in employment, on women’s sedentary behaviour (SB). The onset of motherhood can influence employment status which may subsequently affect SB. Women from disadvantaged neighbourhoods are at particular risk of poor health, volatile employment conditions, and sedentary lifestyle. Among women living in socioeconomically disadvantaged neighbourhoods, this study aimed to determine the association between changes in parental and employment status with sitting, television (TV), and computer time. A second aim was to examine employment status as a moderator between change in parental status and SB.

Methods: Women from socioeconomically disadvantaged areas in Victoria, Australia (age- 18-45 years; at baseline (n=4,349), three years later (n=1912) and five years later (n=1560) self-reported SB and life-events, classified as; change in parental status (no children, number of children remained unchanged, first child/ additional child/ren, fewer children <18 years) and change in employment (remained full-time, remained part-time/not working, decreased working hours, increased working hours). Multilevel modelling adjusted for confounding determined the impacts of life-events on sitting (linear) and TV and computer time (negative binomial). Separate models with interactions terms were used to test the moderator.

Results: Compared to those with no children, less sitting and computer time was observed in women whose number of children remained unchanged, those giving birth to their first child/additional child/ren, and those with fewer children, and less TV time was observed among women who had given birth to their first child/additional child/ren. Compared to those who remained full-time, sitting and computer time was lower for women remained part-time workers/not working, decreased working hours, and increased working hours. Employment status was not a significant moderator of the association between change in parental status and SB.

Conclusion: Among women from disadvantaged neighbourhoods, declines in SB were observed amongst those experiencing life-events. Motherhood appeared to decrease the SB, therefore interventions to decrease SB could target women with no children. Future studies on change in occupation  (e.g., non-manual to manual jobs) and its impact on SB are warranted.   

Purpose: The COVID-19 pandemic is being coupled with a deep socioeconomic crisis worldwide, along with a dramatic increase of food insecurity. The overarching aim of the ECAIL study, which started in 2017 in Northern France, is to test the hypothesis that an intervention combining nutrition education, social support and healthy foods made available at a reduced price, has an impact on diet and growth of young children from disadvantaged families. The objective of the present intermediate analysis was to compare the number of social vulnerabilities of eligible and participating families before and since the beginning of the pandemic. 

Methods: ECAIL is an ongoing randomized controlled trial, implemented at the Lille University Hospital. Pregnant women (objective n=800) from disadvantaged backgrounds are being identified at the maternity ward during their prenatal care, then recruited and followed up by dieticians at home, until their child is aged 24 months. Inclusion criteria include any of the following indicators of social vulnerability: social or medical benefits, unemployment, financial hardship, housing insecurity, or social isolation. Families in the intervention arm are offered the various components of the program, whereas those in the control arm receive usual care. Due to the pandemic, the recruitment of pregnant women in the trial stopped in March 2020 and resumed 6 months later. The eligibility rate, the number of social vulnerabilities and the participation to the trial were compared before and after the beginning of the pandemic.

Preliminary results: 29.6% of the women screened were deemed eligible before the pandemic started vs. 35.9% since then, with eligible families more likely to experience ≥3 vulnerabilities since September (24.0%) than before March 2020 (18.9%). Eligible women participating to the trial have experienced more social vulnerabilities than their non-participating counterparts. Drop-outs have remained rather low (42 out of 248 families included).

Conclusions: The socioeconomic crisis resulting from the pandemic is reflected in the ECAIL trial by the increase of both the eligibility rate and the number of social vulnerabilities experienced by eligible women. This does not seem to impair their engagement in this interventional research; indeed, adherence to this trial has remained stable.

Purpose: The aim of this study was to examine the relative contribution of children’s lifestyle patterns to the development of childhood overweight, and to explore the influence of children’s neighbourhood as an alternative reflection of socio-economic position.

Methods: We included 1818 children participating in the GECKO Drenthe cohort, with information on at least one lifestyle factor between ages 3-6 and data on measured weight and height at the age of 10. Diet was assessed by a Food Frequency Questionnaire, physical activity (PA) by accelerometry (Actigraph GT3X), and other lifestyle factors by questionnaires. Lifestyle patterns were defined using principal component analysis. Height and weight were measured to calculate age- and sex specific standardized BMI z-scores. Linear- and logistic regression models, taking into account socio-economic position, were performed to examine the association between the lifestyle patterns and the development of overweight. In addition, geographically weighted regressions (GWR) were used to explore whether associations were consistent across the study area.

Results: Three lifestyle patterns were identified: 1) ‘activity pattern’ (low sedentary time and high moderate-to-vigorous PA), 2) ‘high sleep/low screen time’ and 3) ‘healthy diet and high outdoor play’. No effect of the ‘activity’ pattern on childhood overweight was found (all p>0.05). In contrast, the ‘high sleep and low screen time’ pattern was associated with a lower zBMI (B[95%CI] = -0.07[-0.11; -0.03] SD) and lower odds to become overweight (OR [95%CI] = 0.77 [0.65; 0.91]) at 10 years of age. Additionally, the ‘healthy diet and outdoor play’ pattern was associated with a lower zBMI (B[95%CI] = -0.04 [-0.08; -0.001] SD), but not significantly with less overweight (p>0.05) at 10 years. The GWR showed that the association between lifestyle and the development of overweight varied across the study area.

Conclusion: These preliminary results show that the lifestyle patterns of ‘low screen time and high sleep’ and ‘healthy diet and high outdoor play’ seem favourable in the prevention of childhood overweight. The geographical differences suggest that there are additional factors in the child’s neighbourhood that influence the development of childhood overweight.

Purpose: Socioeconomic inequalities in diets are common, unfair and avoidable and must be tackled to achieve agreed nutrition and NCD goals. Governments may implement food environment policies like those featured in the acknowledged Healthy Food Environment Policy Index (Food-EPI), a framework encompassing seven evidence-based policies. The equity impact of these policies has however not been appraised. The objective of this umbrella review is to critically assess the diet-related equity impact of six Food-EPI policies and identify knowledge gaps. This is important because Food-EPI projects may influence policy making and therefore also socioeconomic inequalities in diets. 

Methods: We undertook a systematic search for systematic literature reviews in seven academic data bases in September 2019, combining search terms on: Policy interventions; Food, diet and health; Inequality; Study type. Eligible systematic reviews included relevant policy interventions of any quantitative study design; looked at groups from the general population; reported outcomes according to socioeconomic status; assessed diet-related outcomes and were published in English in the past 15 years (2004-2019). Results were analyzed and presented narratively according to policy type and overall direction of results on inequalities (increase/ reduce/neutral/inconsistent effects on inequalities). AMSTAR-2 was used to assess the reviews for bias and quality. 

Results/findings: 16 systematic literature reviews were included, encompassing 169 unique relevant primary studies. They covered five Food-EPI policy areas: food prices (n=13), food in retail (n=4), food labelling (n=3), food provision (school food policies) (n=2), food composition (n=2). Based on AMSTAR 2, quality was mainly low or critically low. The most robust evidence base was for food pricing, suggesting that taxation of unhealthy food may reduce socioeconomic inequalities in diets. For all other policy areas, the evidence base is limited. No results suggest that food environment policies increase socioeconomic inequalities in diets, but for several policy areas results are inconclusive. 

Conclusions: Current research largely fails to provide evidence on equity impacts of food environment policies. There is an urgent need to design and undertake research that can fill this knowledge gap, which is necessary for informing the development of effective and equitable public health policies that “leave no one behind”. 

Aim: To explore adults’ perceptions of sponsorship of unhealthy food, alcohol and gambling products (‘unhealthy commodities’) in elite sport, acceptability of policy options to restrict them, and who was responsible for enacting them.

Methods: Two sets of four focus groups were conducted in Sydney CBD and Western suburbs. Seven to eight participants were recruited for each group, to provide a range of age, gender, and socioeconomic status. The first four focus groups explored broad marketing to children concepts, focusing on unhealthy food and beverages, and identified specific areas of focus for the next round. The second set of four focus groups explored in detail perspectives of sport sponsorship of unhealthy food, alcohol and gambling, and policy options to restrict them, as themes arising from the first set, and targeted recruitment to frequent sport spectators, including parents and non-parents.

Results: Participants recognised the commercial benefit of sport sponsorship, while noting the incongruity of associating unhealthy commodities with elite sport. Support for restricting sponsorship was closely tied to the perceived harm of product, with gambling viewed as having the most negative health impacts, followed by alcohol and fast-food. Sport sponsorship and sport marketing was more persuasive now than ever before, due to the integration of advertisements into broadcasted sport, and immediate access of fast-food or betting through mobile applications. There was greater support for policy measures that reduced the exposure of unhealthy commodities to at-risk groups (i.e. children), rather than banning particular products altogether. Responsibility of enacting changes sat with the government and sports associations.

Conclusion: Australian sport spectators were supportive of policies that limited the exposure of children to gambling, fast-food and alcohol through sport sponsorship. Participants were concerned about the persuasiveness of marketing and harms that may arise from the behaviours encouraged by marketing, particularly from gambling.